The nonprofit, nonpartisan group, with the support of the Robert Wood Johnson Foundation, rated states based on 10 key indicators of steps they can take to prevent injuries. Michigan scored just four out of 10, receiving points for having seat belt and child booster seat requirements, allowing people to get restraining orders against intimate partners, and maintaining an active prescription drug monitoring program.

The state did not meet indicators such as requiring motorcycle helmets for all riders and bicycle helmets for children. Gov. Rick Snyder in April signed a law allowing motorcycle operators 21 or older to ride without a helmet if they meet certain qualifications and have additional insurance coverage.

The report also called out Michigan for not having a strong concussion law. The Michigan Senate is considering a bill that requires athletes under age 18 to be removed from any sports activity if a concussion is suspected. It also calls for the state to create education and training materials for coaches, parents and athletes. The bill could head to the Senate floor in the next couple weeks.

The report also recommended states mandate ignition interlocks for all convicted drunk drivers. The devices prevent someone from starting their car until they pass an alcohol breath test.

Michigan had the 16th lowest rate of injury-related deaths among the 50 states and Washington, D.C., according to the report. Its fatal injury rate was 56.8 per 100,000 adults and children between 2007 and 2009. That’s lower than the national rate of 57.9. New Mexico had the highest rate at 98.7, while New Jersey posted the lowest rate of 36.1.

A fatal injury rate of 56.8 per 100,000 people might not seem like a lot, but injuries from accidents and violence are leading cause of death for Americans ages one to 44, according to the U.S. Centers for Disease Control and Prevention.

“Seat belts, helmets, drunk driving laws and a range of other strong prevention policies and initiatives are reducing injury rates around the country,” Amber Williams, executive director of the Safe States Alliance, said in a statement. “However, we could dramatically bring down rates of injuries from motor vehicles, assaults, falls, fires and a range of other risks even more if more states adopted, enforced and implemented proven policies. Lack of national capacity and funding are major barriers to states adopting these and other policies.”